Osteoporosis and Bone Health

Sonia Kumar Excerpts

Wednesday 22nd April 2026 Westminster Hall

[Sonia Kumar (Dudley) (Lab)]

I beg to move,

That this House has considered osteoporosis and bone health.

It is a pleasure to serve under your chairmanship, Ms Lewell. As a practising physiotherapist, I have seen at first hand the profound and often devastating impact that osteoporosis can have on not only the health, but the independence and livelihood of an individual and the lives of those who care for them. For too long, osteoporosis has been dismissed as an unavoidable consequence of ageing, and we have normalised the gradual stoop, the loss of height, and the curvature of the spine. We all recognise the familiar road sign depicting an elderly couple bent double, yet we rarely stop to question what it truly represents.

In reality, it is not a benign or natural process. It is often the visible consequence of repeated, preventable spinal fractures, where the bone of the spine collapses under pressure. This is not an unavoidable decline; it is, in many cases, a preventable harm.

[Adam Dance (Yeovil) (LD)]

Constituents such as Susan have suffered pain and changes to their life because of osteoporosis. Does the hon. Member share the concern of both Susan and I: that we will not see proper fracture liaison services in overlooked rural areas without a fully funded implementation plan to end the postcode lottery for these services?

[Sonia Kumar]

I believe that we should be rolling those services out across the entire country, and I will come on to that in the rest of my speech. I am sure that the Minister will also comment on that.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady and thank her for the work that she did on this before she came to this place. We are very much indebted to her. Does she agree that the fact that this condition affects one in two women and one in four men over the age of 50 means that there should be greater awareness? The fact that there are some 72,000 people living with osteoporosis in Northern Ireland alone highlights the need to ensure that people know that they can do some things themselves, and that calcium and vitamin D could make such a difference to their quality of life as they age—I speak as one who is ageing quickly.

[Sonia Kumar]

The hon. Member comes to this with a lot of experience. I agree that people do not know what osteoporosis is, which is why we are having this debate. It is important to discuss what it actually is. For those less familiar with it, osteoporosis is a disease characterised by low bone mass and a structural deterioration of bone tissue, resulting in an increase in bone fragility and a susceptibility to fractures. Osteoporosis is asymptomatic and often remains undiagnosed until a fragility fracture occurs. It develops silently, without symptoms, until the moment that it declares itself—a fall from a standing height causes a fracture, or a twist or even a cough causes a low-grade insufficiency fracture. Normal stress has an abnormal effect on the bone. The bone is able to withstand the stress, but because it is of such poor quality, it then crumbles.

--- Later in debate ---

[Rachel Taylor]

As someone who is taking medication to ward off the progression of osteoporosis, I was delighted to welcome Bedford’s new state-of-the-art physical activity hub, which will help residents to stay active and stop their osteoporosis developing. I would like the Minister to explain how the Government will make better use of the growing physiotherapy workforce to deliver early intervention, fracture prevention and rehabilitation in the community in places such as the Bedford physical activity hub.

[Sonia Kumar]

If someone says physio, I am always going to say, “Yes, yes, yes,” behind them. I agree with my hon. Friend that we should roll out physiotherapists and the multidisciplinary teams required to help those with osteoporosis. I also thank her for highlighting the importance of taking bone-sparing medication. Many people in the UK do not take it because they do not understand its importance.

More than 3.2 million people in England now live with osteoporosis, including just over 2.5 million women. One in two women over 50 will suffer a fracture caused by osteoporosis, as will one in five men. In terms of years lost to premature mortality and disability, those fractures are the fourth most consequential medical condition in the country. At any given time, around 7% of NHS beds are occupied by patients with fragility fractures, many of them because early warning signs were missed and opportunities to intervene were lost. Behind those figures are lives changed in an instant.

It is not just older people. One young woman told me:

“I thought my bones were something I wouldn’t have to think about until I was much older”,

only to find herself dealing with low bone density in her twenties after medical treatment. Some risk factors for osteoporosis include smoking, alcohol misuse, previous fragility fractures, low body mass index and long-term steroid use. Every single one of those factors needs to be looked after. We cannot look at osteoporosis as a one-condition problem; we must look at the whole lifestyle.

Through the work of the all-party parliamentary group on osteoporosis and bone health, which I chair, I heard from patients whose stories are not easily forgotten. A woman in her early sixties fractured her wrist after a minor fall. She was treated and discharged, but no one joined the dots. Within two years, she had suffered multiple further fractures, including to her spine. She now lives with constant pain from repeated spinal fractures, affecting everything from how she breathes to how she moves.

I think of those who never recover their independence —of people who go into hospital with a hip fracture and never come home. For many, that fracture marks the beginning of the end, with over a quarter dying within one year. What unites these stories is not bad luck, and they are not isolated tragedies. They are systemic failures: a missed referral, an overlooked warning sign, treatment not initiated, and a second fracture that should not have happened. That is why it is essential that, after a first fracture, every patient is identified, assessed and supported on to an appropriate treatment plan. One fracture must not become many.

Too often, the fall that brings someone into hospital is treated as a single event, rather than as an accumulation of undiagnosed and untreated conditions. We therefore miss the opportunity to change the course of someone’s life. Through the work of the APPG on osteoporosis and bone health, I have also seen stark variations in access to treatment across the country. Prescribing rates for critical second-line therapy are three and a half times higher in areas where GPs can prescribe it freely compared with areas where there is a need for specialist referral. A report has also found that GPs in more affluent areas are much more likely to be able to prescribe freely than their counterparts in the most deprived areas.

For people in many parts of the country, the barriers do not stop at the prescription pad. When shared care arrangements are not in place and GPs cannot prescribe, patients must attend hospital for routine injections that could be delivered safely in the community. As the Government develop the neighbourhood health service, there is a real opportunity for a multidisciplinary team approach to bone health, one that includes at its heart our allied health professionals, including physiotherapists, dieticians, occupational therapists, falls teams, consultants and advanced practice clinicians. Prevention, prevention, prevention is the key. The importance of a holistic approach is essential to prevention for those who may be susceptible to poor bone health. We should help those people lead healthier lives by stopping smoking, reducing alcohol intake and increasing exercise.

Talking of prevention, I need to welcome the Government’s commitment to fracture liaison services, which are the gold standard for fracture care and play an important role in identifying, assessing and treating osteoporosis in people over the age of 50 with a fracture. FLSs reduce fracture rates by up to 40%, and will prevent 74,000 fractures over five years, including 31,000 hip fractures. FLSs are also incredible value for money, breaking even within 18 to 24 months, with a return on investment over five years of £1.88 for every £1. Preventable osteoporotic fractures contribute to 1.5 million days off sick, costing employers £142 million in sick pay.

I also welcome the new DEXA—dual energy X-ray absorptiometry—scanners that the Minister’s Department has delivered, and the Government’s commitment to ending the postcode lottery for fracture prevention services. The Minister understands the scale of what is at stake. This must be only the start of managing osteoporosis and bone health.

Looking ahead, we know that the challenges will grow. By 2047, an estimated 4 million people in England will be living with osteoporosis, an increase of more than 700,000 on today’s figures. We know the scale of the problem, we know the treatments, and we have the evidence. What we have lacked for too long is urgency. There has been clear progress, and the Minister deserves credit for that.

I have three recommendations for the Department. First, we should roll out fracture liaison services to all parts of England. We are a Labour Government, and reducing inequalities is in our blood. We pledged to end this postcode lottery by 2030, and it is crucial that we deliver that. Secondly, we should introduce questions about bone density and osteoporosis in the health check for over-40s. Such pre-emptive measures, including risk stratification, lifestyle advice and early intervention where appropriate, can help people to deal with these issues before they become too serious. Thirdly, we should introduce targeted case finding and proactive bone health management for those aged 70 and above, particularly those at high risk of falls. That should include timely access to DEXA scanning, community-based treatment pathways, and co-ordinated fall prevention to help reduce fractures and associated mortality.

Osteoporosis is not an unavoidable consequence of ageing. It is a condition that we can prevent, predict and treat, yet for too many and for too long the first sign —the fracture—is missed. We know what works and we have the tools. Under the 14 years of the previous Conservative Government, we were missing consistency, urgency and the willingness to act. If we get this right, prevent the first fracture and intervene decisively after it, and ensure equal access to care regardless of postcode, we will not only save the NHS significant cost, but preserve something far more valuable: people’s independence, dignity and quality of life.

I hope that the Minister will consider my three recommendations and meet me to discuss them further. Osteoporosis is not just a clinical issue; it is a test of whether our health system truly prioritises the long-term health of everyone across the United Kingdom, and not reactive, short-term measures.

[The Parliamentary Under-Secretary of State for Health and Social Care (Mrs Sharon Hodgson)]

It is a pleasure to serve under your chairship, Ms Lewell. I thank my hon. Friend the Member for Dudley (Sonia Kumar) for securing this important debate. She continues to work as a physiotherapist alongside her role as a serving MP, so she brings a wealth of valuable professional clinical experience and knowledge to this debate. I would be very happy to meet her afterwards to discuss her three recommendations.

I also thank her for her as the chair of the APPG on osteoporosis and bone health. As an MP for 21 years, I have done lots of work on APPGs, and I am—as I know our Chair today is—a big supporter of all APPGs. The work they do is so important and can really make changes to policy. My hon. Friend’s APPG does important work in raising awareness of osteoporosis, advocating for improvements to the care that patients receive, and promoting behavioural and system changes that are designed to strengthen bones and prevent osteoporosis.

Osteoporosis is estimated to affect more than 3 million people in the UK, and each year over half a million patients present to hospitals with fragility fractures. It is important that we acknowledge the significant impact that osteoporosis can have on individuals and their loved ones. It can seriously impact every aspect of a person’s life, as we have heard, and has a significant impact on the NHS and the wider economy. We hear too often—as we have today—of patients experiencing painful fractures that could have been prevented, of patients living in fear of having further fractures, and the impact that that has on their independence, wellbeing and quality of life. We recognise the importance of bone health and the benefits that early identification of people at risk of osteoporosis and the prevention of fragility fractures can bring.

The 10-year health plan sets out a vision for a health and care system that delivers more personalised, integrated and proactive care for people with long-term and complex conditions, including osteoporosis and other musculoskeletal conditions. More tests and scans delivered in the community, better joined-up working between services and greater use of technology will all support people in the management of osteoporosis. The neighbourhood health service, supported by the neighbourhood health framework that we published last month, will ensure that people can better access care that is joined up, personalised and designed to proactively meet their needs. Initiatives such as Diagnosis Connect will also directly refer patients to specialist charities at the point of diagnosis for personalised advice, information, guidance and support.

Resources are already in place to help support healthcare professionals in the early diagnosis of osteoporosis, such as the National Institute for Health and Care Excellence clinical knowledge summary on osteoporosis and the prevention of fragility fractures. The Royal College of General Practitioners also has an e-learning module for GPs on the diagnosis and management of osteoporosis, developed in collaboration with the Royal Osteoporosis Society—I am sure that my hon. Friend the Member for Dudley was telling me that she was the chair or the president of the society.

[Sonia Kumar]

indicated dissent.

[Mrs Hodgson]

It must have been another body—I am giving her jobs that she has never had.

That e-module is designed to support the early diagnosis of osteoporosis by highlighting which groups are at higher risk of osteoporosis and fragility fractures.

Progress is being made on increasing early diagnosis and management of osteoporosis. Last year, more than 16,000 extra bone density—or DEXA—scans were delivered compared with the previous year, but we recognise there is still much more we can do. That is why on 1 March, the Government announced funding for 20 new DEXA scanners across England, supported by £2.4 million of investment. Tens of thousands of patients will benefit from faster access to bone scans as a result, and it will help ensure that people with bone conditions, such as osteoporosis, get diagnosed earlier.

Fracture liaison services can play a vital role in reducing the risk of refracture, improving quality of life and increasing years lived in good health, which is what we all want to see. The Government and NHS England support the clinical case for services that help prevent fragility fractures and support the patients who sustain them. We are committed to rolling out fracture liaison services to every part of the country by 2030. Integrated care boards remain well placed to make decisions according to local need. The renewed women’s health strategy published last week sets an expectation that ICBs prioritise community-based models when commissioning new fracture prevention services.

However, we need to be honest about the scale of the action needed, the challenges faced across the health and care system, and that change will not be possible overnight. Musculoskeletal community services have the longest waiting lists of all adult community services in England. We know that patients, including those with osteoporosis, are waiting too long for care and treatment, and that needs to change.

To support people with MSK conditions, such as osteoporosis, to access services when they need them, we are delivering the “Getting it right first time” MSK community delivery programme, which is working to transform MSK community services, reduce MSK community waiting times, improve data and metrics, and implement referral pathways to wider support services. As part of a major transformation of the NHS under the 10-year health plan, patients with MSK conditions, such as osteoporosis, will also soon be able to bypass their GPs and directly access community services, including physiotherapy, pain management and orthopaedics, in the NHS app.

The landmark change will deliver faster treatment for the flare-up of existing conditions, while enabling GPs to focus on more complex cases, reducing pressure on hospitals and freeing up GP practices. As we have heard, osteoporosis affects around one in three women, compared with one in five men. We know that women are at greater risk of osteoporosis due to the decrease in oestrogen production at the menopause, which accelerates bone loss.

Since 2022, two new drugs have been recommended by NICE for the treatment of osteoporosis in post-menopausal women. I was so glad to hear the intervention from my hon. Friend the Member for North Warwickshire and Bedworth (Rachel Taylor), who said she had taken some of those new medications. They help to strengthen bones and prevent bone loss, reducing the risk of fractures. The renewed women’s health strategy published last week sets out our ambition to support healthy ageing, maintain independence and improve quality of life for women, while also reducing avoidable pressure on hospital services.

Turning to work and health, the Government are committed to supporting disabled people and those with health conditions, including MSK conditions such as osteoporosis, with their employment journey. We therefore have a range of specialist initiatives to support individuals to stay in work and get back to work. We are joining up health and employment support around the individual through the WorkWell programme, MSK hubs, the MSK community delivery programme, and the individual placement and support in primary care initiative. Measures also include support from work coaches and disability employment advisers in jobcentres, and access to work grants.

We also recognise the benefits of physical activity in improving bone strength and reducing the risk of fractures. We are exploring ways to expand access to MSK physical activity hubs in the community, enabling the delivery of evidence-based physical activity interventions for individuals with MSK conditions. By aligning with employment support at local level, this project will seek to improve both health and work outcomes for people with MSK conditions, such as osteoporosis, while prioritising those experiencing unmet MSK health needs and living in areas of deprivation, with the aim of addressing health inequalities.

I thank my hon. Friend the Member for Dudley again for securing this important debate and all the work she does in this area, and I thank other hon. Members for being present and for raising insightful points during the debate. I hope hon. Members are reassured by some of the measures I have outlined. I recognise that we must go further, but I reaffirm the Government’s commitment to support the millions of people in the UK who are living with osteoporosis to ensure that they get the support they need, including improved diagnosis and management. I look forward to meeting with my hon. Friend.

Question put and agreed to.